[Case of abdominal compartment syndrome (ACS) associated with perforating appendicitis]
Yumi Ando1, Miki Sakamoto, Makito Yokozuka
1Department of Anesthesiology, St. Marianna University School of Medicine, Kawasaki 216-8511.
Insights
Perforating appendicitis in young children can lead to abdominal compartment syndrome (ACS). Early surgical decompression via laparotomy is crucial for managing ACS and preventing multiple organ failure in pediatric patients.
Area of Science:
- Pediatric Surgery
- Critical Care Medicine
- Pediatric Gastroenterology
Background:
- Perforating appendicitis in preschool-aged children has a high rupture rate.
- Abdominal compartment syndrome (ACS) is a severe complication of appendicitis, leading to organ dysfunction.
- Pediatric ACS can present with neurological compromise due to intracranial hypertension and hypercytokinemic encephalopathy.
Abstract:
A 4-year-old girl with perforating appendicitis developed abdominal compartment syndrome (ACS). Appendicitis in children of preschool age is highly likely to rupture, resulting in serious condition. Although we gave priority to systemic management in this ACS case since the child showed disturbed consciousness due to intracranial hypertension as well as hypercytokinemic encephalopathy. However, we should have performed abdominal decompression by laparotomy early. ACS causes progressive multiple organ failure through compromising the respiratory and circulatory systems and injuring multiple organs, leading to generalized inflammatory reactions. We should, therefore, manage ACS patients systemically sharing a notion that they must be treated early with abdominal decompression by laparotomy.
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